Healthcare Provider Details

I. General information

NPI: 1992413611
Provider Name (Legal Business Name): KATELYN ELIZABETH LESTER RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/10/2022
Last Update Date: 11/10/2022
Certification Date: 11/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 7TH AVE S
BIRMINGHAM AL
35233-1711
US

IV. Provider business mailing address

421 LAKESHORE RDG
BIRMINGHAM AL
35211-6962
US

V. Phone/Fax

Practice location:
  • Phone: 615-691-1015
  • Fax:
Mailing address:
  • Phone: 615-691-1015
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License Number1-181430
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: